Tag Archives: vector borne disease

The mummified remains of a young woman from Peru have been analyzed. According to radioactive carbon dating, the woman died around 600 years ago. They know that she was Incan by the way that her skull was modified. (I can talk about pretty much any sort of disease or bodily fluid, even while eating, but this enforced body distortion absolutely creeps me out. Not fond of looking at the faces of mummies, either, for that matter.)

Why was this particular woman sacrificed? The researchers, guessing from DNA found in her, believe that she had Chagas’ disease and that her poor health probably made her a likely candidate. We therefore have another reason not to get Chagas’ disease: you will be more likely to be the one chosen to get tossed into the volcano or offered up à la Fay Wray, albeit to smaller primates and ones with prehensile tails.

THE CHILCANO

We haven’t put a drink recipe on here in a while, and if you are relying on us that you are feeling either pretty thirsty or are sick to death of algorobina cocktails and pisco sours.

The Chilcano was invented in honor of Robinson Canó’s attempt to bring béisbol to Chile, a typically fútbol-mad country. MLB, in the face of waning enthusiasm for baseball, was hoping that the Caribbean locura for the beauty of the diamond would spread to the rest of Latin America, and lead a resurgence in what they hope will be not just America’s pastime, but the Americas’ pastime. Canó, as MVP, was sent as an ambassador. Peru, of course, was in principle opposed to this gesture, not because of any dislike for baseball, but what they saw as yet another attempt by their southern neighbors to appropriate pisco as their own, when everyone (including the EU) knows that Pisco es Peruano.

I like the chilcano because it is easy and it is refreshing.

Into a tall glass filled with ice:

1-2 oz. Pisco

4 oz. ginger ale, ginger beer, or other fizzy mixer.

Squeeze the juice of 1/4 lime

Garnish with a slice of lime.

AND NOW, for the dish: Sylva Koscina was an Italian movie actress, born in the Kingdom of Yugoslavia (now Croatia). She had a successful career in the ’50s and ’60s, and men of a certain age might remember her playing opposite Paul Newman in the The Secret War of Harry Frigg. She invested all of her wealth in a luxurious villa in Rome, but as her income dwindled, she was forced to sell it in order to avoid a charge of tax evasion.

IN SPITE OF WHAT YOU MAY HAVE READ IN MY FAVORITE NEWSPAPER (the NY Times):

Chagas’ Disease, while being a medical nightmare, is not the new AIDS.

The first, and perhaps biggest problem with this article is calling Chagas’ Disease the “new” anything. Chagas’ disease was discovered in 1909 by a brilliant Brazilian scientist, Carlos Chagas. Chagas’ discovery was justly recognized for this great discovery during his own lifetime.

Chagas’ disease is like AIDS, in that it targets certain populations, but that is where the similarity stops. Chagas’ disease is spread by a vector (bugs of the family Reduviidae) that is exquisitely evolved to infect the poor, as it is related to low-quality housing. AIDS does target the poor of the world more than the rich, but there are certain groups that AIDS targeted, or continues to target, that have nothing to do with economic standing. AIDS is not transmitted by arthropod vectors (though there was concern in the early years of the pandemic), but by sexual contact and contaminated transfusions and medical equipment. Chagas’ disease can be spread by transfusion, but this risk is decreasing. As of a few years ago,around two decades after the blood supply began being screened for HIV, the blood supply in the US began being screened for Chagas’ disease.

Chagas’ disease is called a Neglected Tropical Disease. These are diseases that have high prevalence in the hotter regions of the globe, affect a large number of people but yet do not get a lot of attention from the press, their governments, NGOs, and even much of the local population. For example, many residents of Lima (where the power is) don’t even know what Chagas’ disease is, even though it afflicts a large number of Peruvians. Why? It doesn’t occur in Lima, and public education about the disease does not extend to those who won’t get it, even though they may be the ones most able to help.

Stigma: Yes, it sucks to get AIDS or Chagas’ or both together. But tell me from your heart of hearts: Which would you rather tell your co-workers and parents–that you’ve contracted HIV or that you’ve contracted Chagas’. I’m betting on Chagas’. 30 years into the epidemic, and HIV/AIDS still carries a burden unmatched by any other disease.

Research funding: No comparison. HIV/AIDS has been a research juggernaut over much of the pandemic. As a result, we’ve made brilliant and amazing progress in treatment and prevention of the disease. Chagas’ disease is still treated by the same two lousy drugs that were used over a decade ago. Some research is being done on new treatments, but I you’d be embarrassed to see the shoestring some of those labs run on. Moreover, most of these studies involve using drugs that were already approved for other indications, such as anti-fungals and anti-malarials.(They ain’t much money to make sellin’ drugs to po’ folk in the developin’ world.)

Even though this is a public health site, it seems that more people have been led here by the formerly freakishly thin-waisted,

Head, thorax, abdomen..

animal-loving,

buck-toothed,

In her defense, she did say: "Apart from my husband—who maybe will cross over one day as well—I am entirely surrounded by homos. For years, they have been my support, my friends, my adopted children, my confidants."

and proud hate-speech spewer (several times arrested and fined)

WE KNOW that it would be mean-spirited and even provincially gringoish to disparage a great cultural icon and source of pride to the Gallic heart. We just want to give our readers more of what they want, with the ulterior motive of promoting public health.

First of all, lice are very species specific. Cattle lice (there are 4 common kinds in the United States) do not infect sheep. Sheep lice do not infect hogs. And what ever Rick Santorum’s current anxieties are, no species of animal lice infects people. I am sure that he will sleep better knowing this.

Secondly, lice are often quite specific to an area of the body. Human head lice (Pediculis capitis humanus) stay on the head. They do not like moving towards the torso. They like to lay their eggs on hair.

Picture from Wikimedia Commons

Body lice–Pediculus humanus humanus, or sometimes Pediculus humanis corporis–are indistinguishable from head lice, yet except in the laboratory, they will not breed with head lice. They prefer to lay eggs in clothing, especially along the seams. (Bad infestations, therefore, can be prevented by avoiding clothing.)

Thirdly, there is an important distinction between head lice and body lice from an epidemiological point of view. Head lice really don’t cause any serious problems. Kids get sent home from school, squeamish parents lose it and stay up all night itching–even though they are not infested–and the washing machine and vacuum cleaner do overtime. However, other than the chaos and the irrational panic, there is little to worry about.

Body lice, on the other hand, are the vector for some rather serious diseases.

Epidemic typhus

Spread in the feces of lice (like Chagas’ Disease), epidemic typhus is caused by infection with the bacteria Rickettsia prowazekii. Typhus is one of the reasons that, at least until our last couple of wars, more death to soldiers and civilians during conflicts has been caused by germs and disease than by bullets, cannonballs, spears, arrows, bayonets, bombs…..

Trench Fever

Caused by the bacteria Bartonella quintana, trench fever is described as a “moderately serious” disease, and though rarely lethal, was responsible for yet another of the epidemics that plagued soldiers during the War to End All Wars. It is not to be confused with Trench Mouth or Trench Foot, both of which also plagued soldiers in the First World War.

Louse-Borne Relapsing Fever

Caused by Borrelia recurrentis, relapsing fever occurs epidemically in areas of poverty and deprivation. It is currently prevalent in Sudan. If left untreated, mortality rates can reach 30%-70%

Take home message: Head lice don’t cause disease, and war, poverty, and deprivation are bad for your health.

We crossed the Luxan, which is a river of considerable size, though its course towards the sea-coast is very imperfectly known: it is even doubtful whether, in passing over the plains, it is not evaporated and lost. We slept in the village of Luxan, which is a small place surrounded by gardens, and forms the most southern cultivated district in the Province of Mendoza; it is five leagues south of the capital. At night I experienced an attack (for it deserves no less a name) of the Benchuca, a species of Reduvius, the great black bug of the Pampas. It is most disgusting to feel soft wingless insects, about an inch long, crawling over one’s body. Before sucking they are quite thin, but afterwards they become round and bloated with blood, and in this state are easily crushed. One which I caught at Iquique (for they are found in Chile and Peru) was very empty. When placed on a table, and though surrounded by people, if a finger was presented, the bold insect would immediately protrude its sucker, make a charge, and if allowed, draw blood. No pain was caused by the wound. It was curious to watch its body during the act of sucking, as in less than ten minutes it changed from being as flat as a wafer to a globular form. This one feast, for which the benchuca was indebted to one of the officers, kept it fat during four whole months; but, after the first fortnight, it was quite ready to have another suck.

Or does it?

The American Dog Tick (only infects American dogs)

When I was a practicing vet, I saw how the medicine of fear works to beef up the wallets of practicing vets. As much as I like a meaty wallet, I found that hucksterism just isn’t my cup of suet. Am I being hyperbolic? Using too many high-cholesterol food metaphors? Probably. Also, working now in public health, I find that one of main jobs is to instill the proper amount of fear in the population at large.

What’s an appropriate amount of fear?

Why, what we in public health decide is appropriate!

Anyway, if you have a dog, or if you worry about the above vector-borne diseases, or if you have an interest in how medicine can be practiced when it’s just consumer and provider and no third-party payer, read my article from The Bark.

I received this question from Asia Kelly the other day:

Dr. Lerner, thank you for the informative post about Chagas disease. I am a biology student at the University of Texas Pan American in the Rio Grande Valley, South Texas. Last night I believe that I saw an “assassin bug” last night outside of my home near my front door. I am a little worried because I frequently sit outside at night on my porch and I get bitten by what I assumed to be ants or mosquitoes. I’m concerned that I may have been bitten by this insect. I’m wondering if the bite from that bug would cause a rash, swelling, or any sign that it has bitten me. I’m actually very concerned. Also, TV personality Dr. Oz said in a recent show that there is no cure or treatment and that most people will die from chagas in about 20 years. I’m interested in your opinion about this and I’d like to know of any information you might know about the prevelance of this disease in my area. I looked for your email on this site, but cannot find it. Thank you so much.

Ms. Kelly:

You would have to be extremely unlucky to get Chagas’ Disease in the United States. Although Trypanosoma cruzi, the parasite responsible for Chagas’ Disease does exist within our borders, there have only been 7 autochthonouscases, meaning cases acquired here. Admittedly, at least three of those cases were in Texas, but all of those cases were infants, which points out another reason why I don’t think that you are going to get Chagas’: Assassin (kissing) bugs are big bugs, around 2 cm in length. If one gets on you or bites you, you are likely to know it. You can get bitten in your sleep, but we have to remember that it is unlikely that the bugs are in your house. Typically, they live in the cracks in the walls of mud houses, between the bricks of unplastered walls, or in the fronds or thatch that are used for roofing. Some species live outside (like the North American species of triatomines), but these species–judging by the lack of autochthonous cases in the US–don’t seem to pose much danger.

Furthermore, remember that the infectious material is not the insect’s saliva, as it is with tick-borne or mosquito-borne diseases (like ehrlichiosis and West Nile Virus). The parasites are found in the feces of the assassin bugs. That means that if the insect doesn’t defecate while it bites you, it can’t infect. Apparently, the triatomines that we have here in the US don’t have that behavior.

So, while history has shown that it is possible to acquire Chagas’ disease in the US, it has also shown that it is extremely unlikely. Perhaps this will change, either to due to global warming, evolution, or the introduction of a competent vector–either inadvertently or intentionally–into the United States.

As far as vector -borne disease in the Rio Grande Valley go, I’d be more worried about those transmitted by mosquitoes. Dengue, for one, has reared its ugly head along this area, and will probably do so again.

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An Online Journal of Chagas’ Disease, Rabies, Beverages from South America, Dishes from the Sixties, and Other Public Health Issues

If you wish to read the Chagas' Disease primer in order, click here to go to Part 1 and follow the links.
We do not wish to diminish the importance of Chagas' disease, or make it seem that we are equating its significance with that of Pisco Sours or Inca Kola--we realize, alas, that for the most part only geeks and do-gooders are interested in diseases like Chagas'. We are hoping that by including matters of interest to the general public that we may attract more readers.

Richard Lerner

Richard Lerner is the author of this blog. All complaints should be sent to anyone other than him. We are looking for other writers interested in vector-borne disease, or timely information on the fight against these conditions, especially in the Americas.